Most Relevant Information
Provider Data
| NPI Number: | 1003483603 |
| Provider Name: | MICHAEL JOSEPH BISHOP DPT, C-PS |
| Entity Type: | Individual |
| Taxonomy Code: | 261QP2000X |
| Specialty: | Clinic/Center |
| License Number: | PT4085 |
Most Important Dates
| Enumeration Date: | 06/10/2021 |
| Last Updated: | 06/10/2021 |
Provider Practice Location
601 E LINCOLN ST
LAS VEGAS
NM
877014502
Practice Location Phone/Fax
| Phone: | 5054252998 |
| Fax: | 5054252897 |
Provider Mailing Location
9016 RIATO AVE
ALBUQUERQUE
NM
87121
Provider Mailing Phone/Fax
| Phone: | 5059741306 |
| Fax: |